Risk of epithelial ovarian cancer Type I and II after hysterectomy, salpingectomy and tubal ligation-A nationwide case-control study
Risk of epithelial ovarian cancer Type I and II after hysterectomy, salpingectomy and tubal ligation-A nationwide case-control study
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DOI：
10.1002/ijc.33714
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发表时间：
2021-07-07
影响因子：
6.4
通讯作者：
Strandell, Annika
中科院分区：
文献类型：
--
作者：
Darelius, Anna;Kristjansdottir, Bjorg;Strandell, Annika
上皮性卵巢癌（EOC）二元模型的不同起源和途径可能会影响和改变子宫切除术，输卵管切除术和输卵管结扎术相关的潜在风险降低。本研究的目的是分析子宫切除术、输卵管切除术或输卵管结扎术与降低I型和II型EOC风险之间的关系。在这项全国性的基于登记的病例对照研究中，纳入了2008年至2014年期间诊断为EOC，输卵管或原发性腹膜癌的女性。根据组织学和预定义的标准将病例分为I型和II型。暴露变量：子宫切除术、输卵管切除术和输卵管结扎术均来自国家登记研究。进行条件Logistic回归分析，以评估I型和II型EOC与暴露变量之间的相关性。在4669例登记病例中，4040例符合资格并进行了亚型评估，结果为1033例I型和3007例II型。从人口登记册中随机为每个病例分配10个对照。在回归分析中，既往行输卵管切除术的女性患II型EOC的风险显著降低（比值比[OR] 0.62; 95%可信区间[95%CI] 0.45-0.85），但I型EOC的风险不显著降低（OR 1.16; 95%CI 0.75-1.78）。子宫切除术与EOC I型（OR 0.71; 95%CI 0.52-0.99）和II型（OR 0.81; 95%CI 0.68-0.96）的风险降低相关。输卵管结扎术的估计值相似，但无统计学意义。输卵管切除术与降低II型卵巢上皮癌风险之间的相关性支持了高级别浆液性癌起源于输卵管伞部的理论。
The proposed different origins and pathways to of the dualistic model of epithelial ovarian cancer (EOC) may affect and alter the potential risk reduction related to hysterectomy, salpingectomy and tubal ligation. The aim of our study was to analyze associations between hysterectomy, salpingectomy or tubal ligation and risk reduction of EOC Type I and II. In this nationwide register-based case-control study, women diagnosed with EOC, Fallopian tube or primary peritoneal cancer between 2008 and 2014 were included. Cases were classified into Type I and II according to histology and predefined criteria. The exposure variables: hysterectomy, salpingectomy and tubal ligation were identified from national registries. Conditional logistic regression analyses were performed to evaluate associations between Type I and II EOC and the exposure variables. Among 4669 registered cases, 4040 were eligible and assessed for subtyping resulting in 1033 Type I and 3007 Type II. Ten controls were randomly assigned to each case from the register of population. In regression analyses, women with previous salpingectomy had a significantly lower risk of EOC Type II (odds ratio [OR] 0.62; 95% confidence interval [95%CI] 0.45-0.85) but not Type I (OR 1.16; 95%CI 0.75-1.78). Hysterectomy was associated with a reduced risk of both EOC Type I (OR 0.71; 95%CI 0.52-0.99) and Type II (OR 0.81; 95%CI 0.68-0.96). Similar estimates were obtained for tubal ligation, although without statistical significance. The association between salpingectomy and reduced risk of EOC Type II supports the proposed theory of high-grade serous cancer originating from the tubal fimbriae.